Gogol M
Chefarzt der Klinik für Geriatrie, Krankenhaus Lindenbrunn.
MMW Fortschr Med. 2006 Mar 23;148(12):40-3.
At the present time, there is no adequate database for the application of statins for cholesterol lowering in geriatric patients. According to the current position adopted by the IOWiG (Institut für Qualität and Wirtschaftlichkeit im Gesundheitswesen = institute for quality and economy in health care), the usefulness of statins in patients with stable CAD or acute coronary syndrome can be affirmed. The National Institute of Clinical Excellence favors the administration of statins both in primary and secondary prevention of CAD and myocardial infarction, and also as a secondary prevention measure in non-severe stroke, PAD, unstable angina pectoris, and following revascularization procedures on the coronary arteries. Evidence for the superiority of the statins in patients older than 75 is, to date, available only for the indication of CAD in patients with elevated LDL cholesterol, but only up to the age of 80 years. Secondary prevention with statins leading to multipharmacotherapy must be rejected on account of the incalculable risk of side effects and drug interactions.
目前，尚无足够的数据库用于指导老年患者应用他汀类药物降低胆固醇。根据德国医疗卫生质量与效率研究所（IOWiG）目前的立场，他汀类药物对稳定型冠心病或急性冠脉综合征患者的有效性是可以肯定的。英国国家卫生与临床优化研究所支持在冠心病和心肌梗死的一级和二级预防中使用他汀类药物，也支持在非重度中风、外周动脉疾病、不稳定型心绞痛以及冠状动脉血运重建术后作为二级预防措施使用。迄今为止，仅在低密度脂蛋白胆固醇升高的冠心病患者中，有证据表明他汀类药物在75岁以上患者中具有优势，但仅限于80岁以下。由于副作用和药物相互作用的风险难以估量，必须摒弃他汀类药物二级预防导致多药联合治疗的做法。
